Individual provider Active NPI

Wannakuwatte W. Fernando, M.D.

  • Anesthesiology Physician
  • Worcester, MA
National Provider Identifier
1205819281
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
76254 Issued in MA
Practice address
55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002
Phone
(508) 334-3271
Fax
(508) 856-5911
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 76254 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002

Mailing address

280 Chestnut St
2ND Floor
Springfield, MA 01199-1001
Phone (413) 794-5700

Other practice location 1

1 Boston Medical Ctr Pl
Boston, MA 02118-2908
Phone (617) 638-6950

Other practice location 2

759 Chestnut Street
Springfield, MA 01107
Phone (413) 795-0754

Other identifiers 1

IdentifierTypeStateIssuer
3152634MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012000100 MA Practitioner - Anesthesiology 1850351271 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Anesthesia Services LLCGroup PAC ID 4082770136, 127 clinicians
Henry Heywood Memorial HospitalGroup PAC ID 1658262605, 116 clinicians
Tri Anesthesia LLCGroup PAC ID 2062931215, 38 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

300 Grove St
Worcester, MA 01605-3908
Phone (781) 585-9522

60 Hospital Rd
Leominster, MA 01453-2205
Phone (978) 466-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Icon Anesthesia Services of New England LLC Anesthesiology CurrentSince Jun 10, 2025 Accepting new patients
Baystate Medical Practices, Inc CurrentSince Apr 17, 2025 Accepting new patients
Athol Memorial Hospital Incorporated CurrentSince Jul 1, 2020 Accepting new patients
Lawrence Anesthesia Services, LLC Anesthesiology CurrentSince Sep 13, 2021 Accepting new patients
Tri Anesthesia LLC Anesthesiology CurrentSince Jun 15, 2025 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Jul 1, 2020 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Jul 1, 2020 Accepting new patients
Boston University Medical Center Anesthesiologists, Inc. Anesthesiology CurrentSince Apr 15, 2025 Accepting new patients
Central Mass Anesthesia Affiliates Inc. Anesthesiology Past Accepting new patients
Lahey Clinic, Inc. Past Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

725 Albany St
#7C
Boston, MA 02118
Phone (617) 638-6950

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

60 Hospital Rd
Leominster, MA 01453
Phone (978) 466-2000

40 Wright St
Palmer, MA 01069
Phone (413) 284-5210

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

300 Grove St
Worcester, MA 01605
Phone (508) 754-0700

Interoperability endpoints

  • Direct secure messaging: wfernando29972@tuftsmedicine.direct-ci.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1205819281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Boston Medical Ctr Pl",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182908",
            "country_code": "US",
            "telephone_number": "617-638-6950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "759 Chestnut Street",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "01107",
            "country_code": "US",
            "telephone_number": "413-795-0754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "WANNAKUWATTE",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "76254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3152634",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.